JP3649473B2 - Bone plate - Google Patents

Bone plate Download PDF

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Publication number
JP3649473B2
JP3649473B2 JP14842495A JP14842495A JP3649473B2 JP 3649473 B2 JP3649473 B2 JP 3649473B2 JP 14842495 A JP14842495 A JP 14842495A JP 14842495 A JP14842495 A JP 14842495A JP 3649473 B2 JP3649473 B2 JP 3649473B2
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Japan
Prior art keywords
bone plate
edge
subsidence
region
bone
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Expired - Fee Related
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JP14842495A
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JPH07313522A (en
Inventor
テピック スロボダン
ブレシナ ステファン
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AO Technology AG
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Synthes AG Chur
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)
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Description

【０００１】
【産業上の利用分野】
本発明は上側と、骨に接触する下側と、２つの縦の側面とから成る骨板に係るものである。
【０００２】
【従来技術】
螺子やボルトを使って骨に移植片を固定するのに使用する骨板の螺子孔の周りに応力が集中して強度を低下させてその移植片を損壊することがある。骨板の強度を改善する従来の仕方はその重要な箇所の寸法を増大するか、螺子孔の周りに材料を追加するかのいずれかである。
【０００３】
これらの公知の修正の仕方の欠点は健康な組織内への移植片の侵入の増加である。更に、外科手術で骨板をあてがう場合、その骨板の応力集中箇所の寸法をいつも大きくできるとは限らない。
【０００４】
組織の乱れはできるだけ少ないのが望ましい。
【０００５】
【発明が解決しようとする課題】
本発明の目的は、材料は少なくし全体が同じ大きさとなっている板にすることによって上述の問題を解決することである。
【０００６】
【課題を解決するための手段】
応力の極大値を小さくするよう骨板の重要局所の材料を除去する。屈曲荷重をかけた（骨板に近似の）ビームではビームの中心縦軸近くに螺子孔を持ってくると螺子孔の縁の応力を小さくできる。これは螺子孔周りで骨板の上側面から材料を除去して、例えば連続もしくは不連続の縦溝を切ることにより、行われる。点Ａ（螺子孔の縁）の応力と点Ｂ（螺子孔における溝の縁）の応力とが等しくなるとき溝の深さは最適となる。
【０００７】
移植片の下面に横の切れ目がある本発明の別の実施例では螺子孔と螺子孔との間の横断面を減少してはいない。それ故、上面の溝は不連続とされても螺子孔に滑らかに入り込んでいき、螺子孔から滑らかに出て行く。
【０００８】
骨板の下面が凹面となっている本発明の別の実施例では、螺子孔と骨板との間の接触高さは平らな溝を有する骨板の縦の中心線に沿って減少している。骨板の縦の中心線に沿って材料を少なくすべきである。丸刃ののみで螺子孔に滑らかな出入り域をつくるよう切り出して、螺子孔の縁に沿う応力を小さくし、そして骨板の縦の中心線に沿って螺子と全部の高さが接触するようにする。
【０００９】
【実施例】
本発明の新規な様々な特徴は請求の範囲に記述され、この開示部分を構成している。本発明そしてその手術の利点およびその使用により達成される特定の目的のより良い理解のために、添付図を参照して以下に本発明の実施例を説明する。
【００１０】
図１を参照する。骨折３の治療のための従来の骨板１を複数の螺子４により骨２へ固定する。筋力により骨２にかける曲げモーメント１０３が骨２の一側に張力を生じさせ、他側に圧縮荷重をかける。板１を骨２の張力側に当てるのが典型である。それ故、点１００で骨２の半部の間の接触量によって変わる、曲げと引っ張りの組み合わせか、引っ張りだけかのどちらかが板１にかかる。
【００１１】
図２の板１には矢１０３で示す曲げ荷重がかかる。板１の縦の中心線１０４が上面６に示されている。板１の縦側面は数字１０５で示す。上面６もしくは底面７の中立軸５から横断面内で最も遠い距離、すなわち上面６もしくは底面７に最も高い応力が発生する。孔８によってこれらの孔８の縁９に応力を集中させ、これらの応力集中は上面６の引っ張り内力もしくは内部歪みを２乃至３倍増大する。
【００１２】
図３を参照する。孔の縁９を板の横断面の中立軸５に近づけることにより孔の縁９の応力を減少できる。板１に切り込んだ溝１０が孔の縁９を中立軸５へ近づける。点１０１（孔の縁９）における応力と点１０２（孔における溝１０の縁１１）における応力とが等しいとき溝の深さは最適とされる。もし溝がこれよりも深くなると、横断面積１２の減少による強度の損失が孔の縁９における応力の減少により得られるものよりも大きくなる。
【００１３】
図４が示す実施例では板の下面７に横の切れ目１３と縦の切れ目１４とがあって、板と骨との間の接触を減らしている。横の切れ目１３のため孔と孔との間の横断面積１５は既にかなり小さくされており、図３の実施例におけるように上面６に更に溝１０を切ってその横断面積１５をそれ以上小さくすべきではない。それ故、上面６の溝は短い区分溝として不連続として孔８に円滑に移行していくようにしている。
【００１４】
図５に示すように、中心線１０６に沿っての螺子と孔８との間の接触高さは孔の縁における高さ１７よりも小さい。このことによって板の縦軸において螺子が不安定となる。それ故、板の縦の中心線に沿って材料を除去すべきではない。
【００１５】
適当な輪郭の丸のみを使って図６に示す横断面をつくる。この横断面では中心線１０６に沿う接触高さは孔の縁における高さ１７に少なくとも等しい。
【００１６】
図７ないし図９の別の実施例では板に窪み区域１９の形の特殊なオーバカットを設け、それにより孔８への円滑な移行をつくり、そして孔８の縁９に沿う応力を更に減少させる。窪み区域１９の深さは０．２ないし２．０ミリの範囲で目的に適うのであって、孔に近い上側面の孔以外の表面の最大応力が前記窪み区域内の孔の縁における最大応力とほぼ等しいように窪み区域１９の深さを設計する。
【００１７】
図９を参照する。孔８の曲率Ｃ2は比１／ｒ2であり、ここでｒ2は孔８の半径２０である。同様に、曲率Ｃ1は比１／ｒ1であり、ここでｒ1は窪み区域１９の縁１１の半径である。窪み区域１９の縁１１と孔８の縁９との間の距離は矢２２で示されており、そしてこの距離は１．０ミリよりも小さくあるべきであり、好ましくは０．１ないし１．０ミリの範囲内にある。曲率Ｃ1は曲率Ｃ2の６０％よりも小さくあるべきであり、曲率Ｃ2の１０％よりも小さいのが好ましい。
【００１８】
好ましい実施例を上に説明したけれども、本発明の思想の範囲内で様々に変更できることは当業者には明らかであろう。
【図面の簡単な説明】
【図１】 骨板で保持した折れた骨の略図である。
【図２】 骨板の斜視図である。
【図３】 縦溝を付けた骨板の斜視図である。
【図４】 短い溝を孔区域だけに付けた本発明の骨板の斜視図である。
【図５】 螺子孔の中心を通って図４の骨板の縦軸に垂直な断面図である。
【図６】 溝輪郭を変形した、図５と同じ骨板の横断面図である。
【図７】 特殊なオーバカットを有する板孔を通る横断面を含む、斜視図である。
【図８】 図７の骨板の側面図である。
【図９】 図７の骨板の頂面図である。
【符号の説明】
１：骨板、２：骨、３：骨折、４：螺子、５：中立軸、６：上面、７：下面、８：孔、９：孔の縁、１０：溝、１３：横の切れ目、１４：縦の切れ目、１９：窪み区域。[0001]
[Industrial application fields]
The present invention relates to a bone plate comprising an upper side, a lower side in contact with the bone, and two vertical side surfaces.
[0002]
[Prior art]
Stress may concentrate around the screw holes in the bone plate used to fix the graft to the bone using screws or bolts, reducing the strength and damaging the graft. Traditional ways to improve the strength of the bone plate are either to increase the size of its critical points or add material around the screw holes.
[0003]
A drawback of these known correction methods is increased graft penetration into healthy tissue. Furthermore, when a bone plate is applied in a surgical operation, the size of the stress concentration point of the bone plate cannot always be increased.
[0004]
It is desirable that there is as little tissue disruption as possible.
[0005]
[Problems to be solved by the invention]
The object of the present invention is to solve the above-mentioned problems by using a plate with less material and the same overall size.
[0006]
[Means for Solving the Problems]
Material in the bone plate is removed so that the maximum value of the stress is reduced. In a beam subjected to bending load (approximate to a bone plate), if the screw hole is brought near the central longitudinal axis of the beam, the stress at the edge of the screw hole can be reduced. This is done by removing material from the upper side of the bone plate around the screw holes, for example by cutting continuous or discontinuous flutes. The groove depth is optimal when the stress at point A (the edge of the screw hole) and the stress at point B (the edge of the groove in the screw hole) are equal.
[0007]
In another embodiment of the present invention where there is a transverse cut on the underside of the graft, the cross section between the screw holes is not reduced. Therefore, even if the groove on the upper surface is discontinuous, it smoothly enters the screw hole and exits smoothly from the screw hole.
[0008]
In another embodiment of the invention in which the lower surface of the bone plate is concave, the contact height between the screw hole and the bone plate decreases along the vertical centerline of the bone plate with a flat groove. Yes. Material should be reduced along the longitudinal centerline of the bone plate. Cut only the round blade to create a smooth entry / exit area in the screw hole, reduce the stress along the edge of the screw hole, and make the screw and full height contact along the vertical centerline of the bone plate To.
[0009]
【Example】
Various novel features of the invention are set forth in the following claims, which form a part of this disclosure. For a better understanding of the invention and its surgical advantages and specific objects achieved by its use, embodiments of the invention are described below with reference to the accompanying drawings.
[0010]
Please refer to FIG. A conventional bone plate 1 for treatment of a fracture 3 is fixed to a bone 2 by a plurality of screws 4. The bending moment 103 applied to the bone 2 by the muscular force generates tension on one side of the bone 2 and applies a compressive load on the other side. Typically, the plate 1 is applied to the tension side of the bone 2. Therefore, either a combination of bending and pulling or only pulling is applied to the plate 1 depending on the amount of contact between the halves of the bone 2 at the point 100.
[0011]
A bending load indicated by an arrow 103 is applied to the plate 1 in FIG. A vertical center line 104 of the plate 1 is shown on the upper surface 6. The vertical side surface of the plate 1 is indicated by numeral 105. The highest stress is generated at the farthest distance in the cross section from the neutral axis 5 of the top surface 6 or the bottom surface 7, that is, at the top surface 6 or the bottom surface 7. The holes 8 concentrate stresses on the edges 9 of these holes 8 and these stress concentrations increase the tensile internal force or internal strain of the top surface 6 by a factor of 2 to 3 times.
[0012]
Please refer to FIG. By bringing the hole edge 9 closer to the neutral axis 5 of the cross section of the plate, the stress on the hole edge 9 can be reduced. A groove 10 cut into the plate 1 brings the edge 9 of the hole closer to the neutral shaft 5. The groove depth is optimal when the stress at point 101 (hole edge 9) is equal to the stress at point 102 (edge 11 of groove 10 in the hole). If the groove is deeper than this, the loss of strength due to the reduction of the cross-sectional area 12 will be greater than that obtained by the reduction of the stress at the edge 9 of the hole.
[0013]
In the embodiment shown in FIG. 4, there are horizontal cuts 13 and vertical cuts 14 on the lower surface 7 of the plate to reduce contact between the plate and bone. Due to the transverse cut 13, the cross-sectional area 15 between the holes is already considerably reduced, and as in the embodiment of FIG. 3, a further groove 10 is cut in the upper surface 6 to further reduce the cross-sectional area 15. Should not. Therefore, the groove on the upper surface 6 is discontinuous as a short section groove and smoothly moves to the hole 8.
[0014]
As shown in FIG. 5, the contact height between the screw and the hole 8 along the center line 106 is smaller than the height 17 at the edge of the hole. This makes the screw unstable on the longitudinal axis of the plate. Therefore, material should not be removed along the vertical centerline of the plate.
[0015]
The cross-section shown in FIG. 6 is created using only the appropriate contoured circles. In this cross section, the contact height along the center line 106 is at least equal to the height 17 at the edge of the hole.
[0016]
7-9, the plate is provided with a special overcut in the form of a recessed area 19, thereby creating a smooth transition to the hole 8 and further reducing the stress along the edge 9 of the hole 8. Let The depth of the recessed area 19 is suitable for the purpose in the range of 0.2 to 2.0 mm, and the maximum stress on the surface other than the upper surface hole near the hole is the maximum stress at the edge of the hole in the recessed area. The depth of the recessed area 19 is designed to be approximately equal to
[0017]
Please refer to FIG. The curvature C 2 of the hole 8 is the ratio 1 / r 2 , where r 2 is the radius 20 of the hole 8. Similarly, the curvature C 1 is the ratio 1 / r 1 , where r 1 is the radius of the edge 11 of the recessed area 19. The distance between the edge 11 of the recessed area 19 and the edge 9 of the hole 8 is indicated by an arrow 22 and this distance should be less than 1.0 mm, preferably 0.1 to 1.. It is in the range of 0 mm. Curvature C 1 should be less than 60% of the curvature C 2, preferably less than 10% of the curvature C 2.
[0018]
While the preferred embodiment has been described above, it will be apparent to those skilled in the art that various modifications can be made within the spirit of the invention.
[Brief description of the drawings]
FIG. 1 is a schematic illustration of a broken bone held by a bone plate.
FIG. 2 is a perspective view of a bone plate.
FIG. 3 is a perspective view of a bone plate with longitudinal grooves.
FIG. 4 is a perspective view of a bone plate of the present invention with a short groove only in the hole area.
5 is a cross-sectional view perpendicular to the longitudinal axis of the bone plate of FIG. 4 through the center of the screw hole.
6 is a cross-sectional view of the same bone plate as in FIG. 5 with a modified groove profile.
FIG. 7 is a perspective view including a cross-section through a plate hole having a special overcut.
8 is a side view of the bone plate of FIG.
9 is a top view of the bone plate of FIG.
[Explanation of symbols]
1: bone plate, 2: bone, 3: fracture, 4: screw, 5: neutral shaft, 6: upper surface, 7: lower surface, 8: hole, 9: edge of hole, 10: groove, 13: lateral cut, 14: vertical cut, 19: hollow area.

Claims (7)

上面（６）と、骨に接触する下面（７）と、２つの縦の側面（１０５）とから成り、縦の中心線（１０４）と、前記上面（６）から前記下面（７）へ延びる複数の螺子孔（８）とを備え、
Ａ）前記螺子孔（８）は、彎曲縁（９）を有し、前記螺子孔（８）の周りの前記上面（６）の領域（１９）は、前記上面（６）に対して沈下しており、これらの沈下領域（１９）は彎曲縁（１１）を有しており、
Ｂ）前記螺子孔（８）の間に画成されるスパン領域（２５）は前記沈下領域（１９）を有し、前記沈下領域（１９）の深さは前記スパン領域（２５）に向かって縦方向で次第に減少する、さらに、
Ｃ）前記沈下領域（１９）の側縁（１１）は前記縦の側面（１０５）にほぼ平行に延びていて、
Ｄ）前記螺子孔（８）に近い前記上面（６）部分での最大応力は前記沈下領域内での前記螺子孔（８）の縁（９）の最大応力に本質的に等しくなるように前記沈下領域（１９）の深さが決められること、さらに、前記沈下領域（１９）の深さが骨板（１）の縦の中心線（１０４）の方へ次第に減少することを特徴とする骨板。The upper surface (6), the lower surface (7) in contact with the bone, become from the two longitudinal sides (105), the longitudinal centerline (104), extending from said top surface (6) to said lower surface (7) A plurality of screw holes (8) ,
A) The screw hole (8) has a curved edge (9), and the region (19) of the upper surface (6) around the screw hole (8) sinks with respect to the upper surface (6). These subsidence areas (19) have a curved edge (11),
B) The span region (25) defined between the screw holes (8) has the subsidence region (19) , and the depth of the subsidence region (19 ) is toward the span region (25). Gradually decreases in the vertical direction ,
C) The side edge (11) of the subsidence area (19) extends substantially parallel to the vertical side surface (105) ,
D) The maximum stress at the upper surface (6) near the screw hole (8) is essentially equal to the maximum stress at the edge (9) of the screw hole (8) in the subsidence region. Bone characterized in that the depth of the subsidence region (19) is determined and further that the depth of the subsidence region (19) gradually decreases towards the longitudinal centerline (104) of the bone plate (1). Board. 前記沈下領域（１９）の前記縁（１１）は曲率Ｃ 1 を有し、曲率Ｃ1は前記螺子孔（８）の縁（９）の曲率Ｃ2の６０％以下である請求項１に記載の骨板。 Wherein the edges of the subsidence area (19) (11) has a curvature C 1, claim 1 of curvature C 1 is less than 60% of the curvature C 2 of the edge (9) of said screw holes (8) bone plate. 前記曲率Ｃ1は、曲率Ｃ2の１０％以下である請求項２に記載の骨板。The curvature C 1, the bone plate according to claim 2 is not more than 10% of the curvature C 2. 前記沈下領域（１９）の縁（１１）から前記螺子孔（８）の縁（９）への距離（２２）が１ミリ以下である請求項１から３のいずれか１つに記載の骨板。The bone plate according to any one of claims 1 to 3, wherein a distance (22 ) from an edge (11 ) of the subsidence region (19) to an edge (9) of the screw hole (8 ) is 1 mm or less. . 前記骨板（１）の前記下面（７）が凹面となっている請求項１から４のいずれか１つに記載の骨板。The bone plate according to any one of claims 1 to 4, wherein the lower surface (7 ) of the bone plate (1) is a concave surface. 前記骨板（１）の前記下面（７）に横の切れ目を入れた請求項５に記載の骨板。The bone plate according to claim 5 , wherein a transverse cut is made in the lower surface (7 ) of the bone plate (1) . 前記沈下領域（１９）の深さは０．２ミリから２．０ミリの範囲にある請求項１から６のいずれか１つに記載の骨板。The bone plate according to any one of claims 1 to 6, wherein the depth of the settlement area (19) is in the range of 0.2 mm to 2.0 mm.
JP14842495A 1994-05-24 1995-05-24 Bone plate Expired - Fee Related JP3649473B2 (en)

Applications Claiming Priority (2)

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US24923894A 1994-05-24 1994-05-24
US08/249,238 1994-05-24

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JPH07313522A JPH07313522A (en) 1995-12-05
JP3649473B2 true JP3649473B2 (en) 2005-05-18

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EP0684017A1 (en) 1995-11-29
US5733287A (en) 1998-03-31
DE69507911D1 (en) 1999-04-01
CA2144353C (en) 2001-08-21
CA2144353A1 (en) 1995-11-25
JPH07313522A (en) 1995-12-05
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ES2130463T3 (en) 1999-07-01
DE69507911T2 (en) 1999-07-29

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